Module 4 lecture, part 2 Flashcards
Describe the progression of developing effective intervention
Etiologic studies to clinical trials (which demonstrate efficacy) to community demonstrations (which demonstrate effectiveness) to widespread intervention
What is the difference between efficacy and effectiveness?
Efficacy: an intervention working under ideal circumstances
Effectiveness: an intervention having the impact intended in other conditions or circumstances
What are the factors in decision making that should be considered for decision-making for evidence-based interventions?
Size of the problem: importance, PH burden
Preventability: efficacy, biological plausibility, logical
Effectiveness: works in real world? generalizable?
Benefits and harms
Intervention costs: time and money available?
Acceptibility
Appropriateness: context for the intervention
Equitability: distribute resources fairly?
Sustainability
What is the management cycle?
A cyclical process of planning, implementation, and evaluation
What are the key questions to guide program management?
Where are we? (Understanding the problem and resources)
Where do we want to be? (Goals and final outcome objectives)
Should we do something? (Needs assessment)
What should we do? (Identifying determinants and contributors, appropriate interventions, processes, activity plans, budgets)
How do we know we are making progress? (Track activities and progress to objectives)
How is program management in PH judged?
On effectiveness and efficiency
Why is the management cycle cyclical?
Feedback obtained at all steps is used to revise the directions established in proceeding steps
How is effectiveness assessed?
In terms of the degree to which outcomes are reached
How is efficiency evaluated?
In terms of the extent to which an intervention of program achieves goals or objectives with given resources
Program hypothesis
If A and B (main activities of the program) are done, then C will happen (expected changes).
Components of goals
Statements of long-range accomplishment
Provide a programmatic direction
Should state desired outcomes and the target pop
Ambitious and idealistic
No clear deadline
Need NOT be measurable or achievable
What are outcome objectives?
“Ends” or expectations/outcomes/benefits of the program
How are HP goals written?
In relation to health status or quality of life related measures
In what order are objectives written?
Outcome objectives
Process objectives
Activities
What are process objectives?
“Means” that will be used to achieve the “ends” (tasks, service provision)
What are activities?
Refinement of details of program implementation
What do outcome objectives do?
Translate a program goal into precise and measurable language
What are outcome objectives aimed at?
Changes in health status, risk factors, quality of life
What are the key words of outcome objectives?
Increase, decrease
What are intermediate outcome (short-term impact) objectives?
Changes needed before changes in (final) outcome objectives
-Learning objectives related to cognitive factors or skill
-Behavioral objectives
-Environmental objectives
What are final outcome objectives?
The ultimate objectives of a program; the results to be achieved; changes in health status, QOL, risk, social benefits
How could outcome objectives be expressed?
Morbidity or mortality measures
Physiological measures
Consequences of health status
Quality of life measures
What are key words used in process objectives?
Provide, develop, establish, etc.
How are process objectives listed?
For the whole program, each goal, or each outcome objective
What do process outcomes focus on?
Administrative aspects, such as resources, participation, products, and completion of tasks.
What are elements of an objective?
Process or outcome to be achieved (Action, behavior, something that will change as the result of the program)
Condition or time frame of the change
Criterion for determining achievement
Priority for determining achievement
Priority pop or the target of the change
Responsibility in process objectives
